■维奈托克是一种BCL-2抑制剂,在多发性骨髓瘤(MM)和易位t(11;14)的患者中具有证实的疗效。然而,其在浆细胞白血病(PCL)中的作用尚不清楚。在这里,我们的目的是报告1例复发MM继发PCL和t(11;14),通过venetoclax治疗实现完全(CR)和持久缓解.
■一位52岁的绅士在2016年12月被诊断出患有无MM轻链λ(ISSIII)。他接受了诱导治疗,其次是自体干细胞移植。(ASCT)在2017年5月和维护。一年后,患者继发PCL复发。他的细胞遗传学分析显示t(11;14)。患者抢救化疗失败,并转用地塞米松治疗维奈托克。患者达到完全缓解(CR),在他患上致命的COVID-19肺炎之前,这一比例保持了两年半。
■与报道的文献相比,本病例报告提供了关于在PCL患者中使用venetoclax的现有证据的最新汇编.此外,我们的患者达到CR,这是迄今为止文献中报道的持续时间最长的持续缓解.需要前瞻性临床试验来阐明最佳剂量,组合,和治疗持续时间,确保调查结果更好的代表性和概括性。同时,venetoclax可被视为PCLt患者的治疗选择(11;14)。
UNASSIGNED: Venetoclax is a BCL-2 inhibitor with proven efficacy in patients with multiple myeloma (MM) and translocation t(11;14). However, its role in plasma cell leukemia (PCL) remains unclear. Herein, we aimed to report a
case of relapsed MM with secondary PCL and t(11;14) achieving complete (CR) and durable remission with venetoclax therapy.
UNASSIGNED: A 52-year-old gentleman was diagnosed with MM-free light chain lambda (ISS III) in December 2016. He received induction therapy, followed by autologous stem cell transplant. (ASCT) in May 2017 and maintenance. A year later, the patient relapsed with secondary PCL. His cytogenetics analysis revealed t(11; 14). The patient failed salvage chemotherapy and was shifted to venetoclax with dexamethasone treatment. The patient attained complete remission (CR), which was maintained for two years and a half before he developed fatal COVID-19 pneumonia.
UNASSIGNED: In comparison with the reported literature, this
case report offers the latest compilation of the available evidence on the use of venetoclax in patients with PCL. Furthermore, our patient achieved CR for the longest reported durable response in literature thus far. Prospective clinical trials are needed to elucidate the optimal dosage, combination, and duration of treatment, ensuring better representation and generalizability of the findings. Meanwhile, venetoclax may be considered as a therapeutic option in patients with PCL t(11;14).